What is Mastitis?

What is Mastitis?

Mastitis is an inflammatory breast condition that is often characterised by a blocked milk duct/s that may or may not be associated with infection, whether bacterial or fungal. A blockage generally occurs when the accumulated breast milk is unable to drain from the breast, resulting in the thickening of stationary milk which leads to a blockage of the associated milk duct/s. Mastitis usually occurs in breastfeeding mothers, many within the first three to six months postpartum. However, mastitis can occur in women who are not breastfeeding or pregnant and can even happen in small babies.

The symptoms of mastitis can include:

  • Hard, palpable, thickening of the breast tissue
  • Reddening of the breast tissue
  • Flu-like symptoms including fever, achiness and fatigue
  • Symptoms generally occur and progress quickly, often within 24 to 48 hours.

There are several factors which can lead to mastitis, including:

  • Infrequent, missed or rushed feeds
  • Sore or injured nipples
  • Infant latching difficulties
  • Fatigue, stress and lack of sleep
  • Breast compression, e.g. tight clothing, handbags or poorly fitting bras
  • Engorgement or blocked ducts (see below)

What are Breast Conditions Similar to Mastitis?

Some conditions are similar to mastitis, and these include:

  • Blocked or plugged ducts
  • Engorgement

What is Blocked or Plugged Ducts?

A blocked or plugged duct is similar to mastitis in the presentation. However, flu-like symptoms or infection is not associated. Like mastitis, a blockage generally occurs when the produced breast milk is unable to drain from the breast, resulting in an obstruction of the associated milk duct/s.

The symptoms of a blocked or plugged duct/s can include:

  • Hard, palpable, thickening of the breast tissue
  • Reddening of the breast tissue
  • Symptoms generally occur and progress quickly, often within 24 to 48 hours.

Blocked ducts usually resolve spontaneously within 24 to 48 hours after onset. During the time the block is present, your nursing baby may be fussy since milk flow may be slower than usual and may contain a higher concentration of salt.

What is Engorgement?

Engorgement is a condition where the breasts overfill with fluid due to a rapid production or overproduction of milk. Engorgement usually occurs in breastfeeding women in the first week postpartum or with changes in breastfeeding, e.g. transition to weaning.

The symptoms of engorgement can include:

  •  Swelling of the breasts
  • Tight, hard and shiny skin
  •  Achy and tender breast tissue
  • Flattening of the nipples
  • Symptoms generally occur and progress quickly, often within 24 to 48 hours.

Diagnosis of Mastitis

There are many similarities between the different breast conditions. However, mastitis is commonly associated with fever, redness and more intense breast pain. It is not always easy to differentiate mild mastitis from a severely blocked duct. Also, a blocked duct can lead to mastitis if it does not resolve.

Diagnosis of mastitis requires an area of breast hardness, pain and reddening. Fever or flu-like symptoms are not enough to make the diagnosis of mastitis.

Physiotherapy Treatment Options for Mastitis

There are many treatment options for mastitis, including:

  • Education
  • Continue regular breastfeeding on the affected side (if able). Express your milk with a breast pump, if you cannot continue breastfeeding. Breastfeeding helps mastitis to resolve more rapidly. There is no danger to the baby.
  • Drain the affected area more effectively. Position your baby so that their chin “points” towards the hard area. Thus, if the blocked duct is in the outer lower area of your breast (about 4 o’clock), the football position would be best.
  • Heat packs on the affected area also help.
  • Gentle self-massage
  • Regular rest (Not always easy, but take the baby into bed with you)
  • Stay hydrated
  • Therapeutic ultrasound.
  • Kinesiology taping
  • Gentle stretches and breathing exercises

If a blocked duct has not settled within 48 hours, therapeutic ultrasound often assists with the clearance of the blockage. Ultrasound therapy is available at PhysioWorks.

One ultrasound treatment will improve your symptoms, and a second one will finish the job in most cases. Occasionally, further ultrasound treatments are required.

Additional Treatment for Mastitis

  • Please consult your doctor for an assessment. If you have mastitis, you may require medications, including antibiotics.
  • Your doctor may also recommend additional imaging to rule out the possibility of an abscess.
  • Consider a consultation with a lactation consultant for additional information and treatment, especially if your baby is experiencing latching difficulties.
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